Sugar-free chewing gum versus conventional analgesic drugs for pain relief with fixed orthodontic appliances. A systematic review and meta-analysis

Jabr, Luay; Altuhafy, Maryam; Barmak, Abdul Basir; Rossouw, P. Emile; Michelogiannakis, Dimitrios

doi:10.1177/14653125221144059

Cited by 3 publications

(1 citation statement)

References 45 publications

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“…A key concern to patients during orthodontic treatment is potentially experiencing pain [ 21 ]. Recent systematic evidence supports that both pharmacological [ 22 ] and non-pharmacological [ 23 ] interventions may be beneficial in managing patients’ pain symptoms during orthodontic treatment. However, individually patients’ pain experience can be variable [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical evaluation of marketed and non-marketed orthodontic products: are researchers now ahead of the times? A meta-epidemiological study

Alhussain,

Cobourne,

Pandis

et al. 2023

Prog Orthod.

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Background The advertisement and adoption of untested orthodontic products is common. This study aimed to provide an update regarding the prevalence of clinical trials in orthodontics evaluating commercially marketed products. Associations between marketed/non-marketed products and study characteristics such as direction of effect, declaration of conflict of interest and industry sponsorship were evaluated. In addition, within the marketed products associations between direction of effect and study characteristics were explored. Material and methods Electronic searching of a single database (Medline via PubMed) was undertaken to identify Randomized controlled trials (RCTs) published over a 5-year period (1st January 2017 to 31st December 2021). Descriptive statistics and associations between trial characteristics were explored. Results 196 RCTs were analysed. RCTs were frequently published in Angle Orthodontist (18.4%), American Journal of Orthodontics and Dentofacial Orthopedics (14.8%) and European Journal of Orthodontics (13.3%). 65.3% (128/196) of trials assessed marketed products after their introduction. The majority of trials assessed interventions to improve treatment efficiency (33.7%). Growth modification appliances were typically analysed in non-marketed compared to marketed products. An association between the type of product (marketed vs non-marketed) and both the declaration of conflict of interest and industry sponsorship was detected. For individual RCTs assessing marketed products either a positive effect (45.3%) or equivalence between interventions or between intervention and untreated control (47.7%) was evident. In 27% of these trials either no conflict of interest or industry funding was not clearly declared. Within the marketed products, no association between the direction of the effect and conflict of interest or funding was detected. Conclusions The analysis of marketed orthodontic products after their introduction is still common practice. To reduce research waste, collaboration prior to the licensing and marketing of orthodontic products between researchers, industry and manufacturers is recommended.

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Section: Discussionmentioning

confidence: 99%

Clinical evaluation of marketed and non-marketed orthodontic products: are researchers now ahead of the times? A meta-epidemiological study

Alhussain,

Cobourne,

Pandis

et al. 2023

Prog Orthod.

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Effect of chewing gum on orthodontic pain in patients receiving fixed orthodontic treatment: a systematic review and meta-analysis

Guo,

Liao,

Guan

et al. 2023

Eur J Med Res

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Objectives The objective of this systematic review and meta-analysis was to evaluate the effect of chewing gum on orthodontic pain and to determine the rate of bracket breakage associated with fixed orthodontic appliances. Methods This review and its reporting were performed according to the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. Six electronic databases were searched up to March 16, 2023, to identify relevant studies that met the inclusion and exclusion criteria. Furthermore, grey literature resources were searched. The Cochrane Collaboration Risk of Bias tool 2 was used to assess the quality of the included studies. Meta-analysis was conducted using RevMan, and sensitivity analysis and publication bias analysis were performed using STATA software. GRADE tool was used to evaluate the certainty of evidence. Results Fifteen studies with 2116 participants were ultimately included in this review, and 14 studies were included in the meta-analysis. Compared with the blank group, chewing gum had a significant pain relieving effect at all times after fixation of the initial archwire (P ≤ 0.05). No significant difference was found between the chewing gum group and the analgesics group at any timepoints (P > 0.05). Only four studies evaluated the rate of bracket breakage and revealed that chewing gum did not increase the rate of bracket breakage. The sensitivity analysis showed that there was no significant difference in the pooled outcomes after the included studies were removed one at times, and Egger analysis revealed no significant publication bias in included studies (P > 0.05). Conclusions Chewing gum is a non-invasive, low-cost and convenient method that has a significant effect on relieving orthodontic pain and has no effect on the rate of bracket breakage. Therefore, chewing gum can be recommended as a suitable substitute for analgesics to reduce orthodontic pain.

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Chewing Bite Wafers versus Conventional Analgesic Drugs to Relieve Self-Reported Pain Associated with Fixed Orthodontic Appliances: A Systematic Review and Meta-Analysis

Jabr,

Altuhafy,

Barmak

et al. 2024

Applied Sciences

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(1) Objectives: To estimate the impact of chewing bite wafers in reducing pain associated with fixed orthodontic treatment (OT) compared with conventional analgesic drugs (CADs) (Ibuprofen or Acetaminophen). (2) Materials and methods: Unrestricted and manual searching was achieved up to November 2023 and PRISMA guidelines were followed. Randomized controlled trials (RCTs) were included. Meta-analyses were conducted using a random-effects model. The available evidence quality was considered using the GRADE approach. (3) Results: Seven RCTs were included. Five RCTs used the Visual Analog Scale for self-reported pain assessment, while two RCTs used the Numeric Rating Scale. Four RCTs had a high RoB, and three RCTs had a moderate RoB. Separate meta-analyses were performed by pooling quantitative data from two RCTs that compared self-reported orthodontic pain between the bite wafer and Ibuprofen groups and three RCTs that compared the bite wafer and Acetaminophen groups for the different timepoints after orthodontic treatment. None of the timepoints individually indicated a significant difference in pain scores between the bite wafer and control groups, except on day 3, indicating significantly lower pain scores in the bite wafer versus the Acetaminophen groups. The overall level of evidence was very low. (4) Conclusions: Chewing bite wafers is possibly a useful option for CADs to relieve pain during early fixed OT.

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Sugar-free chewing gum versus conventional analgesic drugs for pain relief with fixed orthodontic appliances. A systematic review and meta-analysis

Cited by 3 publications

References 45 publications

Clinical evaluation of marketed and non-marketed orthodontic products: are researchers now ahead of the times? A meta-epidemiological study

Clinical evaluation of marketed and non-marketed orthodontic products: are researchers now ahead of the times? A meta-epidemiological study

Effect of chewing gum on orthodontic pain in patients receiving fixed orthodontic treatment: a systematic review and meta-analysis

Chewing Bite Wafers versus Conventional Analgesic Drugs to Relieve Self-Reported Pain Associated with Fixed Orthodontic Appliances: A Systematic Review and Meta-Analysis

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